Complete the information below concerning the deceased

Name of deceased: ____________________________________

Deceased's social insurance number: _____  _____  _____

The deceased's date of birth: Year ___ Month ___ Day ___

The deceased's date of death: Year ___ Month ___ Day ___

Complete the applicable information below concerning the
surviving spouse or common-law partner

Please update the surviving spouse's or common-law partner's marital status and recalculate the CCTB and/or UCCB.

Please update the surviving spouse's or common-law partner's marital status and recalculate the GST/HST credit.

Please reassess the surviving spouse's or common-law partner's return to allow a claim for the GST/HST credit.

Name of surviving spouse
or common-law partner: _______________________________________

Surviving spouse's or common-law partner's social insurance number: _____  _____  _____

Signature of surviving spouse
or common-law partner: ___________________________________  Date : __________

Your name: _________________________________________

Your telephone number: _____ - _____ - _______

Privacy Act Personal Information Bank number CRA/P-PU-040